What are MSOs?
MSO State Designation Management service organizations (MSOs) have emerged as a way to address the challenges associated with provider adoption of electronic health records (EHRs). These challenges include the cost and maintenance required for the technology, and the responsibilities that accompany the storage of electronic data privacy and security. Unlike the traditional EHR client-server model where the data and technology is hosted locally at the provider site, MSOs offer EHRs hosted in a centralized secure data center. Data is safeguarded through a network operating center that, by design, ensures high quality and uninterrupted service. MSOs enable physicians to access a consumers' record wherever access to the Internet exists. These remotely hosted EHRs enable providers to focus on practicing medicine rather than dedicating staff to support the application.
On May 19, 2009, Governor Martin O'Malley signed into law House Bill 706, Electronic Health Records - Regulation and Reimbursement. This law requires the Maryland Health Care Commission (MHCC) to designate one or more MSOs that will offer EHRs throughout the state by October 2012. COMAR 10.25.15, Management Service Organization State Designation, outlines the requirements for MSO State-Designation. In May 2010, the MHCC began accepting applications for MSO State-Designation Candidacy Status, and in May 2011 the first MSOs were State-Designated.
MSO Advisory Panel
The MHCC convened an MSO Advisory Panel to develop the criteria for MSOs that seek State-Designation. The MHCC will utilize established criteria administered by a nationally recognized accrediting organization. For information on the work of the Advisory Panel click here.
The MSO Advisory Panel will be meeting on June 4, 2013 at the MHCC from 3pm - 5pm.
Initial MSO State-Designation Process
- MSOs must offer at least one hosted EHR solution. MSOs are not resellers and host the products offered and maintain the data center(s) or have an agreement with a third party that hosts the product(s) and maintain the data center(s).
- MSOs must connect to the state designated health information exchange
- The MHCC will evaluate applications for State Designation and issue a formal disposition letter within approximately two weeks of receiving a completed application for Candidacy Status
An MSO will be considered in Candidacy Status based upon the issuance of a disposition letter that acknowledges that the MSO has met the initial documentation requirements for application
- An MSO in Candidacy Status has one year from the date of the disposition letter to successfully complete the requirements for State-Designation
- MSOs in Candidacy Status are afforded the same recognition as MSOs with State-Designation
- To be considered for State-Designation, an MSO must complete a self-assessment evaluation consistent with the established criteria and undergo a site review of their network operating center(s).
- The MHCC will rely on the evaluation of a nationally recognized accrediting organization in determining whether an MSO meets the State-Designation requirements.
- State-Designation is awarded by the MHCC to MSOs that receive a minimum score of 85 percent on their self-assessment manuscript and a similar score on their network operating center site review.
- State-Designation is valid for two years; MSOs interested in reapplying must initiate the application process at least 90 days before the State Designation is scheduled to lapse, and submit the self-assessment manuscript and undergo a site audit no later than 90 days from the State-Designation expiration date.
- MSOs with a State-Designation are required to provide assistance to providers in such areas as EHR planning, implementation, education, technical support, and in becoming advanced users of EHRs.
- MSOs with a State-Designation are required to meet all the performance requirements established by the Regional Extension Center.
- Beginning January 1, 2012, if an MSO in Candidacy Status has not demonstrated accreditation by a nationally recognized accreditation organization identified by the MHCC and achieved State-Designation within the allotted one year timeframe they will be removed from Candidacy Status. Additionally, if the MSO chooses to reapply to the MHCC for State-Designation, the MSO must achieve accreditation from a nationally recognized accreditation organization prior to reapplying
MSO State-Designation Renewal Process
- The MSO submits a completed MSO State-Designation Renewal Application (application) to MHCC at least 90 days prior to the expiration of State-Designation
- The MSO submits a copy of responses to the Electronic Healthcare Network Accreditation Commission (EHNAC) accreditation self-assessment (self-assessment) and EHNAC site visit scoring report (site visit report) at least two weeks prior to the expiration of State-Designation
- MHCC will review the application, self-assessment and site visit report in its determination of State-Designation
- MHCC will send the MSO a letter outlining the final decision for renewal of State-Designation within approximately two weeks of receiving the self-assessment and site visit report from the MSO State-Designation is valid for a period of two years from the date of the award letter
- If a State-Designated MSO has not achieved accreditation by EHNAC prior to the expiration of State-Designation, State-Designation will be revoked. Additionally, if the MSO chooses to reapply to MHCC for State-Designation, the MSO must first achieve accreditation from EHNAC
One Year Anniversary
The MSO State-Designation program has reached its one year mark and we are proud to announce some of our key accomplishments.
MSO State Designation Application and Criteria
Answer a few questions to determine if your organization qualifies to become an MHCC Designated Management Service Organization
State Designated MSOs
For more information on the Maryland Regional Extension, click here
Any organization seeking more information on becoming a State-Designated MSO, please contact: Sarah Orth, 410-764-3449
Last Updated:May 21, 2013